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Early inflammatory profiling identifies patients at risk for persistent pulmonary dysfunction after COVID-19: a

Felipe Dal-Pizzol1, Rafaella de Carvalho Caetano2, Laene de Souza Ribeiro2

  • 1Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina, Criciúma, SC, Brazil; National Institute of Science and Technology Precision Medicine in Intensive Care, Criciúma, SC, Brazil; Intensive Care Unit, Hospital São José, Criciúma, SC, Brazil.

Heart & Lung : the Journal of Critical Care
|July 31, 2026
PubMed

Insights

Identifying early inflammatory profiles in COVID-19 patients can predict long-term lung function. This helps tailor follow-up strategies for better respiratory recovery and personalized medicine approaches.

Area of Science:

  • Pulmonary Medicine
  • Critical Care Medicine
  • Immunology

Background:

  • Limited evidence exists on long-term pulmonary outcomes post-COVID-19.
  • This hinders the development of effective patient follow-up strategies.

Purpose of the Study:

  • To identify patients at risk of persistent pulmonary impairment after COVID-19.
  • To utilize clinical and inflammatory profiles for individualized follow-up and precision medicine.

Main Methods:

  • Prospective cohort study of hospitalized COVID-19 adults.
  • Inflammatory profiling using a 65-plex biomarker panel within 24 hours of ICU admission.
  • K-means clustering identified distinct inflammatory phenotypes (ThHigh and ThLow).
  • Pulmonary function (DLCO, TLC, FEV1, MIP) assessed at 6 and 12 months.
  • Linear mixed models identified predictors of long-term outcomes.

Main Results:

  • Two inflammatory phenotypes identified: high-inflammatory (ThHigh) and low-inflammatory (ThLow).
  • ThHigh group showed significantly higher DLCO (β = 9.44) at 12 months.
  • ThHigh group exhibited significantly lower FEV1 (β = -4.05) at 12 months.
  • No significant associations found between phenotypes and TLC or MIP.

Conclusions:

  • Early inflammatory phenotypes in COVID-19 correlate with distinct long-term pulmonary recovery patterns.
  • Supports early risk stratification to identify patients with persistent respiratory dysfunction.
  • Facilitates personalized follow-up strategies and precision medicine for post-COVID-19 respiratory care.
Abstract

Keywords:
Inflammatory biomarkersInflammatory clustersLong COVIDPost-COVIDPost-acute COVID-19Pulmonary function

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